Ohio § 1753.34

§ 1753.34.

(A) For purposes of sections 1753.31 to 1753.43 of the Revised Code , a “ regulatory action level event ” is any of the following events: (1) The filing of an RBC report by a health insuring corporation that indicates that

the health insuring corporation's total adjusted capital is greater than or equal

to its authorized control level RBC but less than its regulatory action level RBC; (2) The notification by the superintendent of insurance to a health insuring corporation

of an adjustment to the health insuring corporation's RBC report, which adjusted RBC

report shows the health insuring corporation's total adjusted capital within the range

described in division (A)(1) of this section, provided that the health insuring corporation

does not challenge the adjusted RBC report under section 1753.37 of the Revised Code ; (3) The notification by the superintendent to a health insuring corporation, following

the hearing required under section 1753.37 of the Revised Code , that the superintendent has rejected the health insuring corporation's challenge

to an adjusted RBC report showing the health insuring corporation's total adjusted

capital within the range described in division (A)(1) of this section; (4) The failure of a health insuring corporation to file an RBC report by the first day

of March of every year, unless the health insuring corporation has provided an explanation

for such failure that is satisfactory to the superintendent and has cured the failure

within ten days after the filing date; (5) The failure of a health insuring corporation to submit an RBC plan to the superintendent

within the time period set forth in division (C) of section 1753.33 of the Revised Code ; (6) The notification by the superintendent to a health insuring corporation of both of

the following: (a) The RBC plan or revised RBC plan submitted by the health insuring corporation is

unsatisfactory in the judgment of the superintendent; (b) The notification by the superintendent constitutes a regulatory action level event

with respect to the health insuring corporation, provided that the health insuring

corporation does not challenge the determination under section 1753.37 of the Revised Code . (7) The notification by the superintendent to a health insuring corporation, following

the hearing required under section 1753.37 of the Revised Code , that the superintendent has rejected the health insuring corporation's challenge

to the superintendent's determination under division (A)(6) of this section; (8) The notification by the superintendent to a health insuring corporation that the

superintendent has determined that the health insuring corporation has failed to adhere

to its RBC plan or revised RBC plan, and this failure has had a substantial adverse

effect on the ability of the health insuring corporation to eliminate the conditions

leading to the company action level event in accordance with its RBC plan or revised

RBC plan, provided that the health insuring corporation does not challenge this determination

under section 1753.37 of the Revised Code ; (9) The notification by the superintendent to a health insuring corporation, following

the hearing required under section 1753.37 of the Revised Code , that the superintendent has rejected the health insuring corporation's challenge

to the superintendent's determination under division (A)(8) of this section. (B) In the case of a regulatory action level event, the superintendent shall do all of

the following: (1) Require the health insuring corporation to prepare and submit an RBC plan or, if

applicable, a revised RBC plan; (2) Perform such examinations and analyses as the superintendent considers necessary

of the assets, liabilities, and operations of the health insuring corporation, including

a review of the health insuring corporation's RBC plan or revised RBC plan and the

results of any sensitivity tests undertaken pursuant to the RBC instructions; (3) Issue a corrective order, based upon the examinations and analyses performed under

division (B)(2) of this section. (C)(1) The RBC plan or revised RBC plan required by division (B)(1) of this section shall

be submitted to the superintendent within forty-five days after the regulatory action

level event, except by a health insuring corporation that files a challenge to an

adjusted RBC report or revised RBC plan pursuant to section 1753.37 of the Revised Code .  If the superintendent determines the challenge is frivolous, the time limit for

the submission of the RBC plan or revised RBC plan shall not be altered by the filing

of the challenge. (2) If a health insuring corporation files a nonfrivolous challenge to an adjusted RBC

report or revised RBC plan, the RBC plan or revised RBC plan required by division

(B)(1) of this section shall only be submitted to the superintendent if the superintendent

rejects the challenge following the hearing required under section 1753.37 of the Revised Code .  If the superintendent rejects the health insuring corporation's challenge, the RBC

plan or revised RBC plan shall be submitted within forty-five days after the superintendent's

notification to the health insuring corporation of the superintendent's rejection

of the challenge. (D) The superintendent may retain actuaries, investment experts, and such other consultants,

as may be necessary in the superintendent's judgment, to review a health insuring

corporation's RBC plan or revised RBC plan, to examine or analyze the assets, liabilities,

and operation of the health insuring corporation, and to formulate a corrective order

for the health insuring corporation.  The fees, costs, and expenses relating to these consultants shall be borne by the

affected health insuring corporation.